PROPOSAL SUMMARY
Adverse childhood experiences (ACEs) are childhood exposures to potentially traumatic family and community
experiences that can have lasting, negative impact on health, are a driver of health disparities, and have
potential intergenerational transmission of effects. Preliminary data from the parent study for this proposed
study indicate that ACEs are highly prevalent in low-income, urban parents, with 54.7% of 139 parent
participants reporting 4 or more ACEs. Positive childhood experiences (PCEs) are relational experiences that
confer a sense of safety and nurturance during childhood, such as feeling safe with at least one adult in the
home. PCEs are associated with improved physical and mental health. PCEs have the potential to promote
positive outcomes even when ACEs are high. Current neighborhood violence is expected to compound the
impact of ACEs on parenting practices due to ongoing or recurrent activation of neurobehavioral responses to
threat. The purpose of this convergent mixed methods study is to understand how parents' exposures to ACEs
and PCEs impact their parenting practices, particularly in the context of living in unsafe neighborhoods by
addressing the following specific aims: 1: Test the associations among parents' ACEs, PCEs, and more
positive parenting practices in a sample of parents (n=200) raising young children (2-8 years old) in Baltimore.
2: Examine contextual effects of current neighborhood safety (violent crime rate and parent perception) by
testing the interactions between threat-type ACEs and neighborhood safety variables, controlling for other
neighborhood-level SES characteristics. 3: Understand how parents' own childhood experiences (ACEs and
PCEs) influence their parenting practices in the context of low versus moderate to high neighborhood safety.
The proposed study will be nested within an ongoing parent study in Baltimore City Public Schools. The
proposed study will use baseline data only for a cross-sectional quantitative arm, followed by a qualitative arm
that integrates with the quantitative data. Multivariate regression, multilevel modeling, and conditional process
modeling will be used to test associations among ACEs, PCEs, and parenting, and then to test these
associations and the association with neighborhood safety. In the qualitative phase, indvidual interviews will
use an interpretive phenomenological approach to gain a better understanding of the processes and contextual
factors that contribute to participants' parenting in the context of neighborhood safety. This design integrates
the analysis of associations between ACEs, PCEs, parenting practices, and neighborhood safety with analysis
of parents' perspectives on the impact of their childhood experiences on parenting, role of neighborhood
safety, and other contextual variables. This research will identify protective factors in the intergenerational
transmission of ACEs and uses geospatial data to explore how neighborhoods influence the impact of ACEs
and PCEs. It will inform future research on family- and neighborhood-level interventions to promote safe,
stable, nurturing relationships in families and neighborhoods to reduce the rate and impact of ACEs.
